Further reading McDiarmid MA, et al. Health Effects of Depleted Uranium on Exposed Gulf War Veterans: A 10-Year Follow-Up. Journal of Toxicology and Environmental Health, Part A, 2004;67:277–296 Squibb K, McDiarmid MA. Depleted uranium exposure and health effects in Gulf War Veterans. Philosophical Transactions of the Royal Society B: Biological Sciences, 2006;361:639-648. |
Oct 15, 2006—Media reports of increased
leukemia rates among Italian soldiers serving
in the Balkans during the early 1990s
triggered concern about a “Balkans
Syndrome” and led to studies of whether
exposure to battlefield debris from depleted
uranium (DU) armor-piercing weapons may
increase cancer risk.
But now, a study of 14,000 Danish soldiers
deployed to the Balkans between 1992 and
2001 casts new doubt on such a connection
(European Journal of Cancer 2006;42:2355-
2358). The research team, headed by Hans
Storm of the Danish Cancer Society and Hans
Ole Jorgensen of Danish Defense Health
Services, reports no statistically significant
elevations in leukemia incidence among
Danish veterans.
"Cancer incidence [overall] is not increased
among Danish military personnel deployed to
the Balkans," the authors conclude. They note
that long-term follow-up work will be needed to
be certain.
While overall cancer rates are not elevated,
the authors identified a six-fold elevation over
expected rates of bone cancer incidence
among men. Four cases of bone cancer were
diagnosed; no cases had been expected in
this population, based on rates seen among
Danish men.
Three of the four bone cancers identified in
the study were diagnosed within a year of
deployment. Because bone cancers are
believed to require several years to develop
after radiation exposure, the authors doubt
that Balkans deployments are to blame.
"Exposure in the Balkans is unlikely to be
behind these findings and the cause of these
cancers must be found years before
deployment," Storm says.
Others agree. "One to two years is too short a
latency period for bone cancer," says
professor Katherine Squibb, an epidemiologist
and Director of the Toxicology Training
Program at the University of Maryland.
"Elevated rates have not been reported for
bone cancers in DU-exposed cohorts that
have been studied," she says.
The National Academy of Science's Institute of
Medicine (IOM) concludes in a 2000 report
that there is insufficient evidence to determine
whether or not an association exists between
uranium exposure and bone cancer or leukem-
ia.
leukemia rates among Italian soldiers serving
in the Balkans during the early 1990s
triggered concern about a “Balkans
Syndrome” and led to studies of whether
exposure to battlefield debris from depleted
uranium (DU) armor-piercing weapons may
increase cancer risk.
But now, a study of 14,000 Danish soldiers
deployed to the Balkans between 1992 and
2001 casts new doubt on such a connection
(European Journal of Cancer 2006;42:2355-
2358). The research team, headed by Hans
Storm of the Danish Cancer Society and Hans
Ole Jorgensen of Danish Defense Health
Services, reports no statistically significant
elevations in leukemia incidence among
Danish veterans.
"Cancer incidence [overall] is not increased
among Danish military personnel deployed to
the Balkans," the authors conclude. They note
that long-term follow-up work will be needed to
be certain.
While overall cancer rates are not elevated,
the authors identified a six-fold elevation over
expected rates of bone cancer incidence
among men. Four cases of bone cancer were
diagnosed; no cases had been expected in
this population, based on rates seen among
Danish men.
Three of the four bone cancers identified in
the study were diagnosed within a year of
deployment. Because bone cancers are
believed to require several years to develop
after radiation exposure, the authors doubt
that Balkans deployments are to blame.
"Exposure in the Balkans is unlikely to be
behind these findings and the cause of these
cancers must be found years before
deployment," Storm says.
Others agree. "One to two years is too short a
latency period for bone cancer," says
professor Katherine Squibb, an epidemiologist
and Director of the Toxicology Training
Program at the University of Maryland.
"Elevated rates have not been reported for
bone cancers in DU-exposed cohorts that
have been studied," she says.
The National Academy of Science's Institute of
Medicine (IOM) concludes in a 2000 report
that there is insufficient evidence to determine
whether or not an association exists between
uranium exposure and bone cancer or leukem-
ia.
Danish Study Casts Doubt on Leukemia Risk from Balkans Military Deployments
No excess leukemia reported among vets—but an unexpected elevation in bone cancer rate
No excess leukemia reported among vets—but an unexpected elevation in bone cancer rate
| Statistical details Study sample: 13,552 male soldiers, 460 female soldiers SIRs calculated using Danish civilian population data Standardized Incidence Ratios: male cancers: [patient n=84]; 0.9; CI: 0.9,1.1 male bone cancers: [n=4]; 6.0, CI: 1.6, 15.3 male leukemias: [n=4 (all lymphoid)]; 1.4, CI:0.4-3.5 female cancers: [n=12]; 1.7; CI: 0.9-3.0 |
Melissa McDiarmid, medical director of the Veterans
Affairs Depleted Uranium Follow-up Program in Baltimore,
says the VA will continue to study DU's effects on bone
biomarkers. "The relative lack of findings in occupational
cohorts weaken, although they do not completely nullify,
the argument for uranium being a cause of bone cancer,"
she tells epiNews.
Had Danish soldiers encountered significant radiation
exposures in the Balkans, Storm argues, an excess of
leukemias would be expected. None was identified. No
cases of myeloid leukemia were found and only four
cases of lymphoid leukemia were identified. Lymphoid-
specific leukemia rates were not reported in the study.
The absence of a link between Balkans deployment and
leukemia agrees with a previously published study of
Swedish soldiers (Occupational and Environmental
Medicine 2004;61:171-173). To date, no peer-reviewed
epidemiological analysis has confirmed media reports of
elevated leukemia rates in soldiers deployed to the
Balkans.
Because military cancer rates were compared with the
entire Danish population, it is possible that the analysis
(like any comparison of military and civilian cancer rates)
suffers from a "healthy worker" effect, obscuring real
elevations in military cancer rates. This problem can be
avoided, researchers tell epiNews, by comparing disease
rates of individuals exposed to specific military
deploy-ments with other, unexposed military populations.
The study was supported by the Danish Cancer Society
and the Danish Defence Health Services. Professor
Squibb, who was not involved in the Danish study,
receives financial support from the US Dept of Veterans
Affairs. She did not speak to epiNews on behalf of the VA.
Affairs Depleted Uranium Follow-up Program in Baltimore,
says the VA will continue to study DU's effects on bone
biomarkers. "The relative lack of findings in occupational
cohorts weaken, although they do not completely nullify,
the argument for uranium being a cause of bone cancer,"
she tells epiNews.
Had Danish soldiers encountered significant radiation
exposures in the Balkans, Storm argues, an excess of
leukemias would be expected. None was identified. No
cases of myeloid leukemia were found and only four
cases of lymphoid leukemia were identified. Lymphoid-
specific leukemia rates were not reported in the study.
The absence of a link between Balkans deployment and
leukemia agrees with a previously published study of
Swedish soldiers (Occupational and Environmental
Medicine 2004;61:171-173). To date, no peer-reviewed
epidemiological analysis has confirmed media reports of
elevated leukemia rates in soldiers deployed to the
Balkans.
Because military cancer rates were compared with the
entire Danish population, it is possible that the analysis
(like any comparison of military and civilian cancer rates)
suffers from a "healthy worker" effect, obscuring real
elevations in military cancer rates. This problem can be
avoided, researchers tell epiNews, by comparing disease
rates of individuals exposed to specific military
deploy-ments with other, unexposed military populations.
The study was supported by the Danish Cancer Society
and the Danish Defence Health Services. Professor
Squibb, who was not involved in the Danish study,
receives financial support from the US Dept of Veterans
Affairs. She did not speak to epiNews on behalf of the VA.